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NPI Code Detail

MEDICARE: PARKERSBURG ACQUISITION LLC

MEDICARE: PARKERSBURG ACQUISITION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility54WV
2314000000XSkilled Nursing Facility54WV

General Provider Information

NPI Number : 1689918369
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARKERSBURG ACQUISITION LLC
Provider Business Mailing Address
First Line : 700 CHAPPELL RD
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2704
Country : US
Telephone Number : 304-343-1950
Fax Number : 304-343-1947
Provider Business Practice Location Address
First Line : 1600 27TH ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-2815
Country : US
Telephone Number : 304-485-6476
Fax Number : 304-485-1306
Authorized Official
Title or Position : MANAGER
Name : MR. LAWRENCE A PACK
Credential :
Telephone Number : 304-343-1950
Provider Enumeration Date : 11/19/2012
Last Update Date : 05/18/2022

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Directions to “PARKERSBURG ACQUISITION LLC ” Practice Location

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